Cars driving up the costs of health care in British Columbia

My recent research into food issues has awoken me to the crazy dilemma that we’re spending billions in health care costs to pay for the way we eat and move – or don’t move.

The top three leading causes of death in North America – heart disease, cancers and strokes – are all diet- and lifestyle-related. And that’s not taking diabetes into account (it’s No. 6 on the list, right after “accidents”). One in three children born in the U.S. today is expected to get diabetes, mostly because of being inactive and eating junk food. The cost of treating diabetes in Canada was $10 billion in 2000. By 2020, it’ll be up to $17 billion.

This came to mind as I was reading the City of Vancouver’s Transportation 2040 Plan, with its commendable goal to increase the share of foot, bike and transit trips to two-thirds of all trips by 2040, up from 40% in 2008.

Unlike provincial transportation policy, the city’s policy is exactly aligned with health outcomes. Given our staggering health costs, reducing those costs should be top of mind in determining economic benefits from transportation. If we improve goods movement and reduce congestion at the expense of more crashes, pollution and sedentary living, that could be a net economic cost.

Transportation’s biggest contributions to health-care costs are from crashes, pollution and physical fitness. As Victoria transportation analyst Todd Litman found in a recent study for the Victoria Transport Policy Institute (“If Health Matters”; www.vtpl.org), “All three health risks tend to increase with motor vehicle use.” Let’s come clean: cars are a major public health hazard.

“Integrating health objectives into transportation planning may be one of the most cost-effective ways to improve public health,” he concludes.

Maybe we should require a bumper sticker on every car saying, “This car is dangerous to your health and mine.”

Oddly, the word “pollution” appears only once in the 83-page city plan – in relation to diesel buses, which are also health hazards. The city plan points out that physical inactivity cost the provincial health-care system more than $570 million in 2005, and about 45% of British Columbians are now overweight or obese, with the number of obese children three times what it was 25 years ago. It’s probably not a coincidence that the percentage of kids being driven to school has been increasing at comparable rates.

“For many people the most practical way to increase physical activity is to walk or bicycle for recreation and transport,” writes Litman.

In Australia, Litman reports that residents who use public transit average 41 minutes a day of walking or cycling for transport, five times more than the eight minutes for residents who use only their cars.

Looking at crashes, safety for pedestrians (especially the elderly, disabled and very young, the most vulnerable street users) figures prominently in the city report’s recommendations. Pedestrian injuries and fatalities (45% of all traffic deaths, from only 2% of all accidents) cost around $127 million a year in Vancouver, much of it for medical expenses.

High rates of active travel (walking, cycling) in countries like Germany and the Netherlands don’t just improve fitness. They result in pedestrian fatality rates 10 times lower, and bike fatality rates four times lower, than in the U.S. Think of those savings in lives and hospital costs.

Another medical cost of transportation is its impact on personal income, the biggest factor in determining a person’s health. Poverty begets illness. Transportation is the second-biggest cost in most people’s lives. So investments in walking, cycling and transit amenities can add $7,000 a year to personal income if they free someone from having to own a car.

It’s time to look at transportation through a health lens to assess its true economic benefits. •